Provider Demographics
NPI:1396723185
Name:BRILEY, SUSAN C (MD)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:C
Last Name:BRILEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2021 CHURCH ST
Mailing Address - Street 2:SUITE 506
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2021
Mailing Address - Country:US
Mailing Address - Phone:615-284-4224
Mailing Address - Fax:615-284-4225
Practice Address - Street 1:2021 CHURCH ST
Practice Address - Street 2:SUITE 506
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2021
Practice Address - Country:US
Practice Address - Phone:615-284-4224
Practice Address - Fax:615-284-4225
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN25047208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3081497OtherMEDICARE PTAN
TNE75749Medicare UPIN